The hepatitis A virus [HAV] belongs to the picornavirus group erof enteroviruses and it can be cultured though this is only done for research purpose. HAV is highly infectious , is spread by the faecal oral route,and the sources in the community are person incubating or suffering from the disease.Infected persons excrete viruses in the faeces for about 2-3 weeks before the onset of illness and for up to 2 weeks thereafter.Children are most commonly affected and conditions of overcrowding and poor sanitation facilitate spread.In occasional outbreaks water , milk and shellfish have been the vehicles of transmission.Through faeces is the usual source , a transient viraemia in the incubation period occasionally allows infection to be spread by blood and homosexual activity , especially in men. Infection in the community is prevented best by improving social conditions,especially overcrowded and unhygienic situations.

The hepatitis B virus [HBV] IS THE ONLY HEPADNA VIRUS CAUSING INFECTION IN HUMAN.It cannot yet be grown but can be transmitted to certain primates,such as chimpanzee, in which it replicates. Blood is the main source of infection and spread may follow transfusion of infected blood or blood products or infections with contaminated needles,a mode of spread most common among parental drug abusers who shares needles.Blood and blood products used for transfusion are no longer a major source of infection provided that donor blood is tested for the virus , and less than 10% of all post transfusion hepatitis is now attributable to the HBV. Only products such as albumin solutions and gamma globulin which are pasteurized are wholly free of risk. Tattooing or acupuncture can also spread this disease if inadequately sterilized needles are used. B hepatitis can be prevented or minimized by the intramuscular injection of hyper-immune serum globulin prepared from blood containing anti-HBs. This should be given within 24 hours ,or at most a week , of exposure to infected blood in circumstances likely to cause infection ;these include accidently needle puncture ,gross personal contamination with infected blood ,oral ingestion or contamination of mucous membrane ,or exposure to infected blood in the presence of cuts and grazes. Vaccine can be given together with hyper immune globulin.

AT RISK GROUPS MERITING HEPATITIS B VACCINATION IN LOWLY ENDEMIC AREAS.

1. PARENTAL DRUG ABUSERS

2.HOMOSEXULE [MALE]

3.CLOSE CONTACTS OF INFECTED INDIVIDUALS

a.New born of infected mothers. b.Regular sexual partners

4.PATIENTS ON CHRONIC HAEMODIALYSIS

5.MEDICAL /NURSING PERSONNEL

a. dentists b.Surgeons /Obstetricians c.Accident and Emergency department d. Intensive care. e.Liver units f. Oncology units

6.Laboratory staff handling blood The hepatitis C virus [HCV} is an RNA-containing flavivirus which cannot yet be grown but which can infect primates such as the chimpanzee. Human seem to be the sole source of infection, and inoculation with blood or blood products is the best recognized mode of transmission.HCV caused over 90% of post -transfusion hepatitis before serological tests allowed the screening of blood donors, and accounted for the high incidence of chronic hepatitis in haemophiliac patients.Screening of blood donors and heat treatment of coagulation factor concentrates should prevent infection of haemophiliacs in future.Parental drug abusers continue to be at high risk of HCV infection. Sporadic HCV infection also occurs but the modes of transmission are unknown.Sexual and vertical spread may occur but are probably uncommon.Nether active nor passive protection is available. Cirrhosis of liver can occur at any are and often causes prolonged morbidity.It manifests itself particular in younger adults and is an important cause of premature death.Frequent complaints include weakness ,fatigue , muscle cramps,weight loss,and non specific digestive symptoms such as loss of appetite ,nausea , vomiting ,upper abdominal discomfort and gaseous abdominal distension ,liver enlarged, jaundice,ascites,spleen enlarged,male and female disorder ,etc.

TREATMENT :- OUR MODE OF TREATMENT IS SOMETHING DIFFERENT FROM OTHER SYSTEMS. WE INDIVIDUALISE ONE PATIENT FROM ANOTHER THROUGH SYMPTOMS. AFTER PROPER SCANNING OF SYMPTOMS WE SELECT THE REMEDY . SOME FOOD RESTRICTIONS ARE THERE ABSOLUTE REST IS NECESSARY. TOTAL RECOVERY TAKES 3--TO 4 MONTHS TIME.